Carpal Tunnel Syndrome and Food Manual Labor: Case Report and Compensation Issues
Mauro Carino *
Occupational Health Unit, National Health Service, Lungomare Starita 6, 70123 Bari, Italy.
Michele Ostuni
Department of Orthopedics, National Health Service, Lungomare Starita 6, 70123 Bari, Italy.
Daniela Martino
Department of Rehabilitation, National Health Service, Lungomare Starita 6, 70123 Bari, Italy.
Chiara Giorgio
Department of Rehabilitation, National Health Service, Lungomare Starita 6, 70123 Bari, Italy.
*Author to whom correspondence should be addressed.
Abstract
Aims: We report a case of bilateral carpal tunnel syndrome (CTS) in a patient who had been working with repetitive tasks for almost thirty years on his own business as pizza maker in a small restaurant. Food production outside the industry of food processing is often neglected in assessing biomechanical overload as an occupational risk for upper limb musculoskeletal disorders.
Presentation of Case: A 54-year old male reported a progressive history of pain and numbness in the thumb and first three fingers of both hands, including dysaesthesia and nocturnal waking. Main factors influencing the risk such as frequency of repetitive movement, strain, posture, pauses, complementary risk factors are described. On site mini-check list Occupational Repetitive Actions (OCRA) assessed 40/50 technical actions per minute with peak acceleration related to customers’ demand and showed a middle-high risk with score 20.
Discussion and Conclusion: Criteria used for determining eligibility for compensation are not uniform and according to regulations of a single country may cover different aspects of physiological impairment, work disability, healthcare costs, loss of income and professional retraining. This case highlights the importance of using more easily applicable tools for risk assessment that can be crucial for definition and determination of causation.
Keywords: Carpal tunnel syndrome, musculoskeletal disorders, occupational risk, manual labor, food production, compensation